Deep Neck Infections and Descending Necrotising Mediastinitis : Multidis ciplinary Approach. A Review
Abstract:
Untreated or non-responsive to treatment deep neck infections , often arising from odontogenic , oropharyn geal or cervical foci , can result in life-threatening complications of airway obstruction , systemic sepsis and descending necrotising mediastinitis ( DNM ). DNM is a severe , potentially fatal infection , characterized by high morbitidy . It is commonly polymicrobial , spreading downward from head and neck sources through the fascial planes into the mediastinum . Despite advances in diagnosis and treatment , the fulminant course , rar ity , and subtle presentation at the beginning of DNM still contribute to mortality rates of 11 % - 40 % .Survi vors require prolonged hospital stay. Earlier diagnosis is essential to allow more timely airway management and aggressive transcervical and transthoracic debridement and drainage , involving imaging surveillance and repeated intervention(s) to drain residual or persistent collections , all within a multidisciplinary care framework to reduce mortality and morbidity in DNM patients. The aim of the study was to provide a compre hensive review of current knowledge on these still underrecognised conditions , raise clinical awareness , and emphasize the importance of rapid diagnosis and vigorous treatment.
